SELF-CARE CORNER
Know the difference
You’re feeling pretty lousy. You’ve got sniffles, sneezing, and a sore throat. Is it COVID-19, a cold, flu, or allergies? It can be hard to tell them apart because they share so many symptoms. But understanding the differences will help you choose the best treatment.
© American Institute for Preventive Medicine
MEDICAL NEWS
Cystic fibrosis (CF) is an inherited disease that affects 70,000 people worldwide. People who have CF have a gene mutation. This gene mutation causes mucus in the body to become thick and sticky.
With CF, thick mucus in the lungs can cause infections and make it hard to breathe. The pancreas, which helps digest food, becomes clogged. Then the body can’t absorb nutrients from food. This can cause malnutrition and poor growth. CF affects other organs, too.
CF and genetics
People with CF have two copies of the CF gene. They get one copy from each parent. Both parents must have at least one copy of the CF gene.
People with only one copy of the CF gene are called carriers. They don’t have the disease and may not know that they have the CF gene. Each time two CF carriers have a child, the chances are:
* 25 percent (1 in 4) the child will have CF
* 50 percent (1 in 2) the child will be a carrier but will not have CF
* 25 percent (1 in 4) the child will not be a carrier and will not have CF
People with CF can also pass copies of their CF genes to their children. If someone with CF and a CF carrier have a child together, the chances are:
* 50 percent (1 in 2) the child will be a carrier but will not have CF
* 50 percent (1 in 2) the child will have CF
Getting tested for the CF gene
People who are considering pregnancy may wish to get a CF genetic test. This tells you if you have CF or if you could be a carrier. This test looks for the most common CF genes, but it doesn’t test for all of them. If you’re not sure if you need the test, ask your doctor. The decision to get CF testing is a personal one and is different for everyone.
Longer lives for CF
There is no cure for CF. But with proper medical care, people with CF are living longer than ever before. Today, more than half of people who live with CF are over age 18.
Sources: Cystic Fibrosis Foundation, National Institutes of Health
© American Institute for Preventive Medicine
MEDICAL NEWS
Every year, millions of people get the flu. Some get very sick and need to be hospitalized. Thousands of people die from the flu every year.
This year as we battle COVID-19, getting a flu shot is more important than ever. Flu shots decrease the chance that you will be hospitalized or die from the flu. This helps ensure that hospitals will not become overwhelmed with flu and COVID-19 patients.
Won’t last year’s shot help me?
Everyone needs to get a flu shot every year. There are two reasons why:
* Your immune system’s protection from the shot gets weaker over time.
* Flu viruses are always changing, so you need a shot that has this year’s flu strains in it.
Will a flu shot increase my risk of getting COVID-19?
No. Studies have shown that a flu vaccine will not put you at risk for COVID-19. But it will help protect you from the flu, which also protects your loved ones and people around you!
Will the flu shot give me the flu?
The flu shot is made from inactivated flu virus. An inactivated virus cannot give you the flu. Some people notice side effects from the shot like aches or a mild fever. These side effects last only a day or two. This is much milder than getting the flu, where fever, aches and other symptoms last a week or longer.
What if I’m not high risk?
Everyone 6 months of age and older should get the flu shot, even if they have no health problems. Even young, healthy people – including children – can become very sick with the flu.
When more people get the flu shot, we help protect people who are high risk, including babies, older adults and people who are allergic to the shot.
Is it too late to get a flu shot?
Even if you haven’t gotten your flu shot yet, it’s not too late. After getting the shot, you won’t have immunity right away. It takes about two weeks for your body to develop antibodies to the flu.
Source: Centers for Disease Control and Prevention, World Health Organization
© American Institute for Preventive Medicine
MEDICAL NEWS
The winter months are a peak time for the spread of infectious respiratory diseases. Cold weather often keeps people indoors, where it is easier for infections to spread.
Infectious respiratory diseases include the common cold, as well as other respiratory illnesses that can be more serious. Some people may be at increased risk of severe side effects from respiratory disease, including the elderly, children, and the immunocompromised.
Preventing the spread of respiratory disease helps keep everyone in your family and community safe. A few simple precautions can make all the difference. Once you know how these diseases are spread, you can take steps to contain them and make this winter a healthy one.
Airborne transmission
The most common way infectious respiratory diseases spread is by small aerosols that become airborne when an ill person coughs, laughs, talks, or sneezes. These tiny aerosols can hang in the air for hours and easily travel to the lungs when inhaled.
Surface transmission
Contact with a surface that is contaminated with droplets from an infected person is another route of transmission. If you touch something that has saliva or mucus on it and then later touch your mouth or face, you can become infected with the virus.
Close contact transmission
Being in close contact with someone infected with a virus can result in exposure to large virus-laden respiratory droplets. In contrast to the tiny aerosols that can hang in the air for an extended period, larger droplets fall quickly and most likely to spread when people are less than 3 feet apart.
Types of infectious respiratory viruses
* Chickenpox
* Coronavirus infections (including SARS-CoV and MERS-CoV)
* Diphtheria
* Influenza (flu)
* Legionnaires’ disease
* Measles
* Middle East Respiratory Syndrome (MERS)
* Mumps
* Pneumonia
* Pneumococcal meningitis
* Rubella (German measles)
* Severe Acute Respiratory Syndrome (SARS)
* Tuberculosis
* Whooping cough
Prevent the spread
* Minimize close contact with ill people.
* Wash your hands regularly with soap and water.
* Don’t share personal items such as food and utensils.
* Ask your doctor which vaccines are recommended for you, including the flu and COVID vaccines.
* Cover coughs and sneezes with your elbow and tissues (not your hands!).
* Stay home if you are ill.
© American Institute for Preventive Medicine
SELF-CARE CORNER
Chronic congestion? Watery, itchy eyes? Sneezing and coughing? These may be symptoms of an allergy.
If your doctor diagnoses you with an allergy, they may recommend allergy shots. For the right person, an allergy shot regimen may bring much-needed relief from frustrating and ongoing symptoms.
The cause of allergies
An allergy occurs when the immune system attacks an allergen. This creates mucous and the classic allergy symptoms. Allergens are substances that are usually not harmful, but the immune system over-reacts to them, causing an allergy. Common allergens include:
* Mold
* Pollen
* Dander
* Dust mites
* Grass
* Ragweed
* Animal dander
How allergy shots work
Each allergy shot contains a small amount of an allergen. When the immune system senses the allergen, it responds by producing an antibody. Antibodies neutralize and block the allergen from causing symptoms.
In general, the goal of an allergy shot regimen is to reduce the body’s reactivity to the allergen. By introducing a small dose at a time, the immune system learns to identify and quickly neutralize the allergen. Over time, your immune system becomes more efficient and reduces allergy symptoms.
Benefits of allergy shots
Many different medications are available to treat allergies. However, for some people, those do not bring relief. Their doctor may recommend allergy shots as a safe and effective treatment to help them feel better. Shots may:
* Reduce allergy symptoms
* Reduce asthma symptoms for some people
* Reduce the risk of future allergies
* Reduce the need for other allergy medications
Drawbacks
Allergy shots are not for everyone. Your doctor is your best resource to determine the right treatment for your allergies. Drawbacks of allergy shots include:
* Possible redness or swelling at the injection site
* Potential for a severe reaction
* Requires frequent visits to your doctor
* Not appropriate for people with certain medical conditions
* Not used for food allergies
© American Institute for Preventive Medicine
SELF-CARE CORNER
It’s the season for colds and flu – and that means coughing. Coughing is an important function in your body. It helps clear your airways. Many times, a mild cough will go away on its own. But when should you see a doctor about a cough?
Common cold
A common cold may cause some coughing. When you have a runny nose, the fluids drain down your throat. This causes your cough reflex to kick in. It’s a way your body protects your lungs. Although a cough from a cold can be annoying, it usually goes away quickly. Antibiotics won’t help with a cough related to a cold.
Bronchitis
Bronchitis is an inflammation in the tiny tubes in the lungs. These tubes are called bronchioles. Viruses and bacteria can get into the bronchioles and make you sick. Chemicals and toxins like tobacco smoke can also invade the bronchioles and lead to bronchitis.
Symptoms of bronchitis include:
* Coughing, especially with mucus
* Wheezing or feeling short of breath
* Low fever
* Chest pain
Bronchitis is most often caused by a virus so antibiotics will not help. Rest, drinking more fluids and a humidifier can help you feel better.
Pneumonia
Pneumonia is an infection in the air sacs inside the lungs. These sacs are called alveoli. Pneumonia can range from mild to serious. If you have pneumonia, you may notice:
* Cough with greenish, yellow or bloody mucus
* Fever, sweating and chills
* Trouble breathing
* Stabbing chest pain that hurts when you cough or take a deep breath
* Loss of appetite
* Feeling weak or tired
* Nausea and vomiting (common in small children)
Many times, a doctor will give you antibiotics for pneumonia. Be sure to take them exactly as your doctor tells you. Pneumonia can be life-threatening if it is not treated effectively.
Pertussis (Whooping cough)
Pertussis is very contagious. It may seem like a cold at first. People may have a runny nose or mild cough.
As it gets worse, pertussis causes a severe cough that can last weeks or even months. The cough makes a high-pitched “whoop” sound. It’s especially dangerous for babies and people with weak immune systems.
The best way to protect against pertussis is to get vaccinated. If you aren’t sure whether you’re vaccinated, ask your doctor. Pertussis is treated with antibiotics.
Sources: American Lung Association, Centers for Disease Control and Prevention, National Heart, Lung, and Blood Institute
© American Institute for Preventive Medicine
MEDICAL NEWS
As concern increases about Middle Eastern Respiratory Syndrome, or MERS, in the Middle East and in Asia, Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, answers questions on what we need to know about this emerging infectious disease.
What is MERS?
It is a serious lower respiratory infection caused by the MERS coronavirus. This emerging viral pathogen was first acquired from camels, but now has limited human-to-human transmission.
What are the symptoms?
The symptoms include fever, cough, and respiratory symptoms that could lead to respiratory failure and other organ system breakdown. This infectious disease is similar to SARS (severe acute respiratory syndrome) that caused a severe and highly lethal outbreak in South China in 2002-2003. Some data from previous SARS outbreaks indicate that 13% of cases may have no symptoms and this could also be true for MERS.
How is it spread?
The mode of spread is still not well known. In general, it involves close contact, especially in health care settings. For SARS, a related coronavirus, sneezing and cough seems to facilitate transmission.
Is there a treatment? Is there a vaccine?
There is no proven antiviral treatment, yet, for MERS. Several prototype vaccines are in different stages of development.
Who is at risk? Any groups more at risk?
For about 30 to 40%, of people who get MERS, the disease is fatal. At greatest risk of dying are the elderly and those with underlying heart and lung disease or diabetes.
Should we be concerned?
The MERS epidemic in South Korea looks as though it will be contained soon with all new cases appearing among the estimated 3,000 people in quarantine. However, in Saudi Arabia and elsewhere on the Arabian Peninsula, new cases continue to appear. Individuals thinking about travelling to the Arabian Peninsula should consult their doctor if they are elderly or have underlying chronic disease conditions.
© American Institute for Preventive Medicine
Respiratory conditions
Asthma is a chronic disease that causes the airways to narrow. Airflow is limited due to inflammation in the airways.
General Information
Symptoms
* A cough lasts more than a week. Coughing may be the only symptom. It often occurs at night or early in the morning.
* Shortness of breath. Breathing gets harder and may hurt. It is harder to breathe out than in.
* Wheezing (high pitched whistling sound)
* Tightness in the chest
Causes & Risk Factors
* Genetic Factors. You are more likely to have asthma if other members of your family have or had it.
* Environmental Factors. Being exposed to certain things can set off an immune system response for asthma to develop. Examples are house-dust mites and viral respiratory infections.
Diagnosis
A doctor diagnoses asthma from:
* Your medical history
* Your family’s medical history
* Your symptoms
* A physical exam
* Lung function tests in persons age 5 years and older
* Other tests to check for conditions that have symptoms of asthma, but are not asthma
Asthma Attack Triggers
People with asthma have very sensitive airways. Exposure to triggers causes a response in the airways called an asthma attack or an asthma episode.
With an asthma attack:
* Air becomes trapped in the lungs.
* The lining of the airways becomes inflamed.
* The muscles around the air tubes tighten.
* Thick mucus clogs the airways.
(The last three things cause the airways to narrow.)
Problems That Make It Harder to Manage Asthma
* Reflux of stomach acids which cause heartburn, belching, or spitting up
* Being overweight or obese
* Allergic rhinitis or sinusitis
* Sleep apnea that obstructs breathing
* Stress and depression
Treating these problems may help improve asthma control.
Common Asthma Attack Triggers
* Respiratory infections (colds, flu, bronchitis, etc.)
* Tobacco smoke
* Dust mites
* Animal dander (small pieces of skin, hair, or feathers from warm-blooded animals, such as dogs, cats, birds, etc.)
* Cockroach droppings
* Molds (indoor and outdoor)
* Strong odors and sprays from paints, new carpet, perfumes, etc.
* Air pollution
* Cold air and changes in temperature and humidity. Weather changes can also affect how much pollen and mold are in the air.
* Having strong feelings (laughing, crying, etc.)
* Sulfites. These are additives in wine and some foods, such as processed potatoes and dried fruits. Shellfish packed in ice that has sulfites can pick up the sulfites from the ice.
* Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
* Beta blocker medicines. These are prescribed for heart disease, high blood pressure, and migraine headaches.
When to Seek Medical Care
Reasons to Call Doctor
Call your doctor when you feel the first change in your asthma status. Deal with a problem early to help prevent a severe problem.
* You have asthma and have a cold or a fever.
* You cough up mucus that is bloody-colored, green, or yellow.
* An asthma attack does not respond to your medication.
* Medication is not helping like it used to.
* Your peak expiratory flow (PEF) numbers are in the yellow zone.
* You have a harder time breathing or you are short of breath more often than before.
* You breathe faster than usual.
* Your asthma attacks are coming more often or are getting worse.
* You use your rescue medication more than 2 times a week.
Reasons to Get Medical Care Fast
* Your peak expiratory flow (PEF) numbers are in the red zone.
* You have a fever with heavy breathing.
* You have extreme shortness of breath. It may feel as if you can’t breathe at all. Or, you can’t say 4 or 5 words because you are so short of breath. Call 911!
* You cough so much that you can’t take a breath. Call 911!
* Your lips or fingernails are bluish in color. Call 911!
Focus on breathing slow and easy until you get medical care. Sit upright. Try to remain as calm and relaxed as you can.
Peak Flow Meters
These devices measure peak expiratory flow (PEF). PEF is the amount of air blown out after taking a deep breath. Your PEF readings can tell you and your health care provider:
* About asthma triggers
* If an asthma attack is starting. PEF is decreased with an asthma attack.
* If your medicine plan is working
* When to add or stop medicine
* How severe your asthma is
Use your peak flow meter, as directed by your doctor or health care provider.
Find Your Personal Best Peak Flow Number
Your personal best peak flow number is the highest peak flow number you can get over a 2-week period when your asthma is under good control. Good control is when you feel good and do not have any asthma symptoms.
Take peak flow readings:
* Twice a day for 2 weeks – when you wake up and about 10 to 12 hours later
* Before and after taking an inhaled beta2-agonist (if you take this medicine)
* As advised by your doctor or health care provider
The Peak Flow Zone System
Once you know your personal best peak flow number, your health care provider will give you the numbers that tell you what to do. The peak flow numbers are put into zones that are set up like a traffic light.
Green Zone (80 to 100 percent of your personal best number). This signals all clear. No asthma symptoms are present, and you may take your medicines as usual.
Yellow Zone (50 to 80 percent of your personal best number). This signals caution. You may need to take more of your asthma medicine(s) to treat your asthma. Or, your overall asthma may not be under control, and the doctor may need to change your asthma action plan.
Red Zone (below 50 percent of your personal best number). This signals a medical alert. You must take an inhaled beta2-agonist right away and call your doctor without delay if your peak flow number does not return to the Yellow or Green Zone and stay in that zone.
Treatment
The goals of treatment are to:
A. Prevent asthma attacks and control or treat asthma symptoms as they occur
B. Allow normal daily activities, including exercise
C. Promote restful sleep, free from waking up with asthma symptoms
D. Do A, B, and C with few or no side effects from asthma medications
E. Have no need for emergency medical care or to be hospitalized due to asthma
Treatment for asthma varies on how severe it is and how well it is controlled. Since a person’s asthma can change over time and the response to medications may be age-related, asthma treatment guidelines are given for three different age groups:
* 0-4 years
* 5-11 years
* 12 years and older
A good way to help you manage your asthma is to follow a written action management plan that you develop with your doctor or health care provider. Your plan should include:
* What to do daily to avoid and deal with your asthma triggers and what to do when you have an asthma attack
* Names and doses of medicines to take daily and when you have specific symptoms
* Reasons to contact your doctor or to get medical care fast
* Your plan should be tailored for your needs.
Keep a journal of your asthma symptoms. Include:
* When you had symptoms and what may have caused them. What you did to treat the symptoms. List the medicines you took, how you took them, and how much you took.
* Your peak flow meter readings. Record these before and after treatment steps.
* Results of the treatment steps you took
Self-Care
* Know your warning signs and peak flow zones so you can begin treatment early. Monitor your peak expiratory flow rates. (See “Peak Flow Meters”.)
* Keep your asthma rescue medicine handy.
* Get a yearly flu vaccine, as advised.
During an asthma attack:
* Sit up. Don’t lie down.
* RELAX. Keep calm. Focus on breathing slow and easy. Remove yourself from any stressors.
* Take the right amount of medicine, as prescribed in your asthma control plan. Call your doctor if you need to take more medicine than prescribed.
Avoid your asthma triggers
* Do not smoke. Do not allow smoking in your home, car, or around you. Avoid air pollution.
* Use bedding, flooring, paint, vaccum cleaners, toys, and other products that are “Certified Asthma & Allergy Friendly™.” (Search for items fromwww.asthmaandallergyfriendly.com.) It is especially helpful to use these products in your bedroom and/or:
– Sleep with no pillow or one your doctor suggests. Use a “dust-mite proof” cover to enclose your mattress and pillow (if you use one). Wash all bedding in hot water every week.
– Try not to keep stuffed animals in the bedroom. If you must, have only one that can be washed. Wash it in hot water once a week.
– Use curtains and rugs that can be washed often. Avoid carpeting, bed ruffles, and throw pillows.
– Get someone else to vacuum and dust once or twice a week. Use a vacuum with a HEPA filter or double-thickness bags. If you dust or vaccum, wear a dust mask.
– Reduce clutter in your bedroom. Store items in plastic containers with lids.
– It is best not to keep a TV, DVD-player, etc. in your bedroom. These, too, can collect dust.
* Put an air filter on your furnace or use a portable air purifier, such as one with a HEPA filter.
* Stay out of the cold weather as much as you can.
* Change and/or wash furnace and air conditioner filters on a regular basis. Keep indoor humidity below 60 percent.
* When you are outside in cold weather, wear a scarf around your mouth and nose to warm the air as you breathe in.
* Stop exercising if you start to wheeze.
* If you are sensitive to sulfites, don’t take foods or medicines that have them. Sulfites are in wine, some processed potatoes and dried fruits. Shellfish packed in ice that has sulfites can pick up the sulfites from the ice.
* Drink plenty of liquids (2-3 quarts a day) to keep secretions loose.
* Don’t take over-the-counter medications unless cleared first with your doctor or health care provider.
– Antihistamines dry nasal secretions and can cause airways to plug up by making secretions thicker. Antihistamines are also found in some cold remedies, so check labels.
– Some ulcer drugs increase the effects of some bronchodilators.
– Aspirin can trigger an attack in 3-5 percent of persons with asthma who have nasal polyps. Acetaminophen doesn’t have this effect.
Medications
Some medications are to be taken with an asthma attack. Other kinds are taken daily (or as prescribed) to help prevent asthma attacks.
Long-Term Control Medicines
These are taken daily (or as prescribed) to help prevent asthma attacks. Examples are:
* Corticosteroids. These help with the swelling in the airways that cause asthma symptoms. They can prevent, reduce, and/or reverse the swelling.
– Inhaled corticosteroids (ICSs). These are the most effective long-term medicines that control asthma. These are not the same as anabolic steroids that athletes may abuse.
– Oral corticosteroids. An example is prednisone. These are usually given for a short time, when a person’s asthma is not being controlled. Long-term use of these may be prescribed for persons with severe asthma that persists.
* Cromolyn sodium and nedocromil. These help prevent swelling in the airways when exposed to asthma triggers. They treat mild asthma that persists.
* LABAs (long acting beta2-agonists). These are bronchodilators. They relax the muscles of the airways. They are usually taken with ICSs to help control moderate and severe asthma and to help prevent symptoms during the night.
* Leukotriene modifiers. These prevent swelling in the airways and decrease mucus in the lungs. They treat mild asthma that persists or are combined with ICSs to treat moderate or severe asthma.
* Theophyllines. These are mild to moderate bronchodilators that may have mild anti-inflammatory effects.
* Medicines that modify the body’s immune response.
Quick-Relief Medicines
These are used to treat symptoms of an asthma attack. They help stop asthma symptoms before they get worse. They may be prescribed for use at other times, too, such as before exercising. Examples are:
* SABAs (short-acting beta-agonists). These are bronchodilators. They work quickly to relax the muscles of the airways and open up the air passages in the lungs and are the treatment of choice to relieve acute symptoms. They are usually taken in an inhaled form.
* Anticholinergics. These help prevent airway muscles from tightening and help keep mucus from forming. These are usually taken in an inhaled form.
With proper treatment and monitoring of symptoms, asthma can be controlled. People with asthma can live active and healthy lives.
Resources
The Asthma and Allergy Foundation of America
800.7.ASTHMA (727.8462)
National Heart, Lung, and Blood Institute
301.592.8573
© American Institute for Preventive Medicine
WELL-BEING
Maybe you’ve never been allergic to ragweed. You may not be miserable at the end of summer during ragweed season like a lot of other people.
But even if you’ve never had a problem with seasonal hay fever caused by ragweed, don’t assume that runny nose and itchy eyes are caused by a cold.
The truth, according to the American College of Allergy, Asthma and Immunology, is that anyone can develop an allergy-including an allergy to ragweed-later in life.
Scientists think it may be you’ve always had the allergy, but it might have taken exposure to another allergen to trigger your symptoms. If symptoms won’t go away, lasting more than 2 weeks, you probably have allergies.
Common allergy symptoms include itchy eyes and nose, as well as sneezing, but the mucus is typically clear.
You’ll want to talk with your doctor first about over-the-counter medications to try to relieve those annoying symptoms.
© American Institute for Preventive Medicine
Respiratory conditions
In colder climates, cold, dry air can irritate the airways and lungs. When you are outside in cold weather, wear a scarf and try to breathe through your nose. Don’t let indoor air drop below 64 degrees. Regularly use a nasal saline spray or gel. If you have pre-existing lung conditions, such as asthma, avoid using any wood-burning fireplaces in the winter. The smoke from the fire may also irritate your nasal passages. And, stay on top of your medication regimens.
Be More Earth-Friendly
When it gets cold outside, bring your plants inside! Find a sunny spot in a well-lit area of your house. Only water indoor plants when the soil feels dry and avoid placing them near air vents.
© American Institute for Preventive Medicine